It’s extremely important that our resources go to those truly in need. While there’s no set formula for financial screening, we try to use common sense. In some situations, we will waive the financial need criteria; however, this decision must remain at our discretion.
Do You Qualify? To find out if you qualify, go to Passenger Qualifications.
Medical Release Form: Patients must be able to be transported in an unpressurized small aircraft. After the patient has been qualified for our services and subsequently scheduled for a mission, we will fax a Medical Release Form to the patient’s physician who must complete, sign, and return the form to us prior to the scheduled mission.
The Medical Release Form is available below in two different formats if you need a copy for any reason.
Medical Release Form (PDF) – This version can be downloaded and printed. Then it should be completed and signed by the physician, and faxed back to us.
Medical Release Form (Online) – This version can be downloaded and completed on your PC if you have Microsoft Word (you will have to Enable Editing after this form opens if you are using Word 2010). Afterwards, the form should be printed and signed by the physician, and faxed back to us.
Do You NeedMore Information?
Patients, please ask your social worker or physician to call:
Mercy Flight Southeast Hotline (888) 744-8263.
In need of our services but you reside outside of Alabama, Georgia, Mississippi, or South Carolina? Please check the Air Charity Network™